Candidates for Endoscopic thoracic sympathectomy

ETS can be used for people of all ages, although no surgeon will operate on someone under the age of 16 without parental consent.  ETS does appear to work best for young adults, however some older people do also have the surgery with success.

The best candidate for ETS would be someone who:

• Is above the age of 18
• Knows all of the risks involved with the surgery
• Has explored all other options available for their hyperhidrosis
• Is fit and healthy with no known heart or respiratory problems
• Has hyperhidrosis of the palms or face

If you don’t meet all of these points then it is not the case that you definitely cannot have ETS.  It is best to discuss any queries that you may have with a relevant surgeon in order to clarify whether you can have the treatment or not.

Endoscopic thoracic sympathectomy (ETS) Procedure

• In a hospital you will be placed under a general anaesthetic for the procedure, with an anesthetist as well as your surgeon and support staff on hand.
• The surgeon will cut under the arms, and reduce the size of the lungs using air in order to reach the nerves that control the amount that you sweat.  If you are only having one side treated only one incision will need to be made.  Each side of your body has the relevant nerve chain running down through the ribs of the same side.
• Using small cameras and working tools your surgeon will cut the appropriate nerves, removing parts of the sympathetic nerves.  There are many ways to do this, some surgeons cut the nerve, others burn them, some clamp them.  Ultimately the result is the same, and there doesn’t appear to be a best method to do this.  The method used will depend on your surgeon’s preferences, experience and training.
• The surgeon will then remove all equipment and restore the lungs to their normal capacity.
• You will have your incision stitched up.

The whole process takes around an hour to perform, and generally you will be able to leave the hospital within a few hours in order to recuperate at home.  In some cases you will have to stay overnight, especially if any complications have arisen during the surgery.

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